Researchers call EHRs 'pivotal' in proactive population based care management

Using an electronic health record is key for primary care providers to actively manage their population of patients and proactively identify those at higher risk who may benefit from screening, treatment and interventions, according to a new study in JMIR Medical Informatics.

The researchers, from SUNY at Binghamton, McGill University and elsewhere, wanted to determine whether the type of records kept affected a primary care provider's preparedness to engage in practice based population health (PBPH) management. They created the Canadian Population Health Challenge to measure such preparedness.

Eleven primary care clinics participated, of which three used paper records and eight used EHRs. They completed time-controlled, evidence-based practice reviews of their patients who could likely benefit from evidence-informed care and treatment in five different areas: immunizations, post myocardial infarction care, cancer screening, diabetes management and medication recall.

The researchers found that clinics using EHRs completed a full review of their charts in an average of 1.37 hours. The paper-based clinics could only review 10 percent of their charts in 3.9 hours, which indicates that they would need 40 hours for a complete review. There was a seven-fold difference between the best performing paper-based clinic and the worst performing EHR clinic. There also was a large gap between the best performing EHR-using clinic and the worst one.

"The use of an EMR seems pivotal in setting the foundation to support PBPH management in primary care and subsequently to drive the associated beneficial outcomes for patients and clinicians," the authors said. "The range of capacity in EMR-enabled clinics suggests that for PBPH management to be effectively undertaken, key determinants of EMR optimization need to be addressed."

The researchers noted some limitations to the study, such as a small sample size, and the fact that measures used were not "rigorously" validated. The study also occurred in 2011, when providers were more inclined to see EHRs as electronic charts rather than data analytics tools.

However, the authors stated that the information can help assess which primary care providers are better prepared to take these population-health related proactive steps and help vendors and policy makers regulate and improve EHR systems, data bases and functionalities.

EHR data is proving to be helpful in many areas, such as identifying undiagnosed diseases, new types of disease and even patients who are not filling their prescriptions.

To learn more:
- here's the study